Evaluation of the Effect of Implementing the “Zero-Dose” Children Identification Strategy on Vaccination Coverage in Konseguela, 2024

Introduction: "Zero-dose" children are those who have not received any dose of routine vaccines. These children represent a major challenge to achieving vaccination coverage goals, especially in rural areas where geographic inaccessibility, mistrust of health services, poverty, and parental ignorance contribute to their lack of vaccination. In Konséguéla, an active search strategy for zero-dose children was implemented in 2024 with the support of community health workers and local leaders. This study was conducted to assess the effect of implementing the "zero dose" child search strategy on vaccination coverage in Konséguéla, comparing the results with those of a control site (Kôkô) where the strategy was not applied.  Methodology: This was a before-and-after study with a control site, retrospective and analytical, using a mixed-methods approach. A non-probability sampling method was used. Data collected were analyzed using IBM SPSS Statistics 25 and Excel 2016. The tools included a questionnaire and an interview guide to identify challenges related to the vaccination of zero-dose children.  Results: The study revealed a clear increase in vaccination coverage rates in Konséguéla after the implementation of the strategy: (BCG: 61.21% → 95.06%) ;(Penta1: 84.67% → 90.12%) ; (Penta3: 86.32% → 90.43%) et (VAR1-RR1: 88.27% → 90.33%). In Kôkô, the control site, the coverage rates remained generally stable. The comparison of these averages using the Wilcoxon test showed that there was no statistically significant difference between the two periods. The main barriers identified were: low educational level of parents, difficult geographic accessibility, socio-cultural barriers, forgetfulness or refusal from fathers, lack of information, family displacement, logistical constraints, limited resources, and lack of parental motivation.  Conclusion: Overall, the study shows that the zero-dose child tracing strategy implemented in Konséguéla in 2024 did not lead to a significant improvement in vaccination coverage, despite an observed increase in coverage rates after the strategy was introduced. These findings support international recommendations to integrate the identification and tracing of unvaccinated children into routine immunization programs, particularly in areas with low coverage or high dropout rates.